疏肝通络针刺法联合帕罗西汀治疗卒中后抑郁症临床疗效及对神经递质、细胞因子表达水平的影响  

Clinical Observation of Soothing Liver and Dredging Collateral Acupuncture Combined with Paroxetine in Treatment of Post-stroke Depression and Its Effect on Expressions of Neurotransmitters and Cytokines

作　　者：吴金隆 杨堃[1] 李优锋 尤圆圆 叶必宏[1] WU Jinong;YANG Kun;LI Youfeng;YOU Yuanyuan;YE Bihong(Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中医院,浙江温州325000

出　　处：《中华中医药学刊》2024年第6期224-227,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省基础公益研究计划项目(LGF18H270001);温州市科技局基金项目(Y20220226)。

摘　　要：目的通过随机对照研究,研究疏肝通络针刺法联合帕罗西汀治疗卒中后抑郁症(PSD)患者的临床疗效观察及对神经递质、细胞因子表达水平的影响。方法利用随机数字表法将医院2022年7月—2023年1月收治的90例PSD患者分为研究组(45例,疏肝通络针刺法+帕罗西汀)和对照组(45例,帕罗西汀);对比两组临床疗效,治疗前后抑郁情况[抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)]、生活质量,治疗前后神经递质[同型半胱胺酸(Hcy)、5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NA)]、细胞因子[白细胞介素-1(IL-1)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]等水平,记录不良反应情况。结果治疗8周后,总有效率研究组高于对照组(P<0.05);两组HAMD、SDS评分均下降(P<0.05),且研究组均低于对照组(P<0.05);研究组生活质量量表评分均高于对照组和治疗前(P<0.05);两组Hcy、IL-1、TNF-α均降低,且研究组低于对照组(P<0.05);两组5-HT、DA、NA及IL-10均升高(P<0.05),且研究组均高于对照组(P<0.05);研究组不良反应总发生率低于对照组(4.44%vs 17.78%,χ^(2)=4.050,P<0.05)。结论对PSD患者给予疏肝通络针刺法联合帕罗西汀治疗,可获得更好地治疗效果,可有效缓解患者抑郁情绪,调节神经递质、细胞因子水平,且不良反应较少。Objective To study the clinical efficacy of soothing liver and dredging collateral acupuncture combined with paroxe-tine in the treatment of post-stroke depression(PSD)and its influence on the expressions of neurotransmitters and cytokines through randomized controlled study.Methods Ninety patients with PSD admitted to the hospital from July 2022 to January 2023 were randomly divided into study group(45 cases,soothing liver and dredging collateral acupuncture+paroxetine)and control group(45 cases,paroxetine).The clinical efficacy,depression[self-rating depression scale(SDS),Hamilton depression scale(HAMD)],quality of life,levels of neurotransmitters[homocysteine(Hcy),5-hydroxytryptamine(5-HT),dopamine(DA),norepinephrine(NA)],cytokines[interleukin-1(IL-1),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)]be-fore and after treatment were compared between the two groups.Adverse reactions were recorded.Results After 8 weeks of treat-ment,the total effective rate of the study group was significantly higher than that of the control group(P<0.05).The scores of HAMD and SDS in the two groups were decreased(P<0.05),and the scores in the study group were lower than those in the con-trol group(P<0.05).The scores of quality of life in the study group were higher than those in the control group and before treat-ment(P<0.05).The levels of Hcy,IL-1 and TNF-αin the study group were lower than those in the control group(P<0.05).The levels of 5-HT,DA,NA and IL-10 in the study group were higher than those in the control group(P<0.05).The total incidence of adverse reactions in the study group was lower than that in the control group(4.44%vs 17.78%,χ^(2)=4.050,P<0.05).Conclusion soothing liver and dredging collateral acupuncture combined with paroxetine can obtain better therapeutic effect in PSD patients,and can effectively relieve depression,regulate neurotransmitters and cytokines levels,and has fewer adverse reactions.

关 键 词：疏肝通络针刺法 帕罗西汀 卒中后抑郁症 疗效 神经递质 细胞因子 

分 类 号：R245.37[医药卫生—针灸推拿学]